Article metrics

  • citations in SCindeks: 0
  • citations in CrossRef:0
  • citations in Google Scholar:[=>]
  • visits in previous 30 days:6
  • full-text downloads in 30 days:0
article: 3 from 3  
Back back to result list
Anestezija i intenzivna terapija
2004, vol. 27, iss. 2, pp. 159-167
article language: Serbian
document type: Case Report

Analysis of the most common causes of nosocomial pneumonia in artificially ventilated patients
aUniversity of Novi Sad, Faculty of Medicine
bKlinički centar Novi Sad

Abstract

We analysed causes of ventilator- associated pneumonia. Study included all patients with mechanical ventilation longer than 72 hours in last 6 months 2003. year. There were 41 patients - 11 women and 30 men, average age of 51. Microorganisms were isolated and identified from tracheal secretions of 35 patients (85%) and first time from specimens taken average 8.8 day of mechanical ventilation. From 76 specimens 29% were negative and 71% positive. Isolates were monomicrobial in 44% and polimicrobial in 56% of cases (41% dimicrobial, 15% trimicrobial). Isolated bacterial species were: Acinetobacter spp in 36%, Pseudomonas aeruginosa in 25%, Staphylococcus aureus in 15%, Klebsiella spp in 8%, Enterobacter spp in 7%, Stenotrophomonas maltophilia in 4% of cases, and all other species in 5% of cases. Acinetobacter spp is most often isolated 5.-6. day of mechanical ventilation, Klebsiella spp 5.-9. day and Staphylococcus aureus 7.-20. day. The number of isolates with Pseudomonas aeruginosae is constant during this period. Acinetobacter spp showed least resistance to meropenem and kotrimoxazol, Pseudomonas aeruginosa to tazocin and meropenem, Staphylococcus aureus to vankomycin, and other species to: amikacin, meropenem, imipenem, ciprofloxacin and ceftriaxon.

Keywords

References

Bauer, T.T., Ferrer, R., Angrill, J., Schultze-Werninghaus, G., Torres, A. (2000) Ventilator-associated pneumonia: Incidence, risk factors, and microbiology. Semin Respir Infect, 15(4): 272-9
Bergmans, D.C., Bonten, M.J., van Tiel, F.H., Gaillard, C.A., van der Geest, S., Wilting, R.M., de Leeuw, P.W., Stobberingh, E.E. (1998) Cross-colonisation with Pseudomonas aeruginosa of patients in an intensive care unit. Thorax, 53(12): 1053-8
Bregeon, F., Ciais, V., Carret, V., Gregoire, R., Saux, P., Gainnier, M., Thirion, X., Drancourt, M., Auffray, J.P., Papazian, L. (2001) Is ventilator-associated pneumonia an independent risk factor for death?. Anesthesiology, 94(4): 554-60
Chastre, J., Fagon, J. (2002) Ventilator-associated pneumonia. Am J Respir Crit Care Med, 165(7): 867-903
Combes, A., Figliolini, C., Trouillet, J., Kassis, N., Wolff, M., Gibert, C., Chastre, J. (2002) Incidence and outcome of polymicrobial ventilator-associated pneumonia. Chest, 121(5): 1618-23
Cook, D.J., Walter, S.D., Cook, R.J., Griffith, L.E., Guyatt, G.H., Leasa, D., Jaeschke, R.Z., Brun-Buisson, C. (1998) Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med, 129(6): 433-40
Ewig, S., Soler, N., Gonzalez, J., Celis, R., El-Ebiary, M., Torres, A. (2000) Evaluation of antimicrobial treatment in mechanically ventilated patients with severe chronic obstructive pulmonary disease exacerbations. Crit Care Med, 28(3): 692-7
Fink, J.B., Krause, S.A., Barrett, L., Schaaff, D., Alex, C.G. (1998) Extending ventilator circuit change interval beyond 2 days reduces the likelihood of ventilator-associated pneumonia. Chest, 113(2): 405-11
Heyland, D.K., Cook, D.J., Griffith, L., Keenan, S.P., Brun-Buisson, C. (1999) The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am J Respir Crit Care Med, 159(4 Pt 1): 1249-56
Kaneko, Y., Yanagihara, K., Kuroki, M., Ohi, H., Kakeya, H., Miyazaki, Y., Higashiyama, Y., Hirakata, Y., Tomono, K., Kadota, J.I., Kohno, S. (2001) Effects of parenterally administered ciprofloxacin in a murine model of pulmonary Pseudomonas aeruginosa infection mimicking ventilator-associated pneumonia. Chemotherapy, 47(6): 421-9
Lynch, J.P. (2001) Hospital-acquired pneumonia: Risk factors, microbiology, and treatment. Chest, 119(2 Suppl): 373S-384S
Manojlović, D., ur. (2000) Interna medicina. Beograd: Zavod za udžbenike
Mihajlović-Ukropina, M., Jelasić, Z., i dr. (2003) Rezistencija na antimikrobne lekove najčešće izolovanih bakterijskih vrsta uzročnika respiratornih infekcija u 2002. godini. Pharmaca iugoslavica, Novi Sad, 41, str. 37-40
Morehead, R.S., Pinto, S.J. (2000) Ventilator-associated pneumonia. Arch Intern Med, 160(13): 1926-36
Pietrzyk, A., Wojkowska-Mach, J., Bulanda, M., Heczko, P.B. (2000) Hospital acquired pneumonia: Analysis of frequency and etiology in Polish hospitals in 1998. Przegl Epidemiol, 54(3-4): 259-69
Rello, J., Sonora, R., Jubert, P., Artigas, A., Rue, M., Valles, J. (1996) Pneumonia in intubated patients: Role of respiratory airway care. Am J Respir Crit Care Med, 154(1): 111-5
Silvestri, L., Milanese, M., Oblach, L., Fontana, F., Gregori, D., Guerra, R., van Saene, H.K.F. (2002) Enteral vancomycin to control methicillin-resistant Staphylococcus aureus outbreak in mechanically ventilated patients. Am J Infect Control, 30(7): 391-9
Tejada, A.A., Bello, D.S., Chacon, V.E., Munoz, M.J., Villuendas, U.M.C., Figueras, P., Suarez, F.J., Hernandez, A. (2001) Risk factors for nosocomial pneumonia in critically ill trauma patients. Crit Care Med, 29(2): 304-9
Woske, H.J., Roding, T., Schulz, I., Lode, H. (2001) Ventilator-associated pneumonia in a surgical intensive care unit: Epidemiology, etiology and comparison of three bronchoscopic methods for microbiological specimen sampling. Crit Care, 5(3): 167-73